The Tsunami of New Type 1 Cases: Why The Rise?

For the last several months, I've been hearing about the increases in Type 1 Diabetes, but being caught up in my day-to-day demands, I never thought much of it.

Not until I took the time to read the article, "A Child's Plague," in the most recent issue of the science magazine Discover, did I snap to attention. The piece, written by medical journalist and author of Diabetes Rising Dan Hurley, stated there has been a 3% annual increase in the incidence of Type 1 Diabetes, meaning that the number of new cases of Type 1 will double in 23 years - which is just one generation. The incidence of children in Europe under the age of five diagnosed with Type 1 is expected to double by 2020, just a decade away.

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To add more context, consider this: a little over 100 years ago in 1890, the incidence of Type 1 Diabetes in children under the age of 15 was at 1.3 per 100,000 (noting that this is a death rate since Type 1 was fatal in those days). By the mid 1980s, the incidence per year had increased to 14.8 per 100,000 in Colorado, which is one of the only states collecting sound data on the incidence of Type 1 Diabetes. Then, in 2007, the CDC estimated the incidence of Type 1 in the U.S. was 19 in 100,000. They revised the figure upward to 23.6 cases for every 100,000 only two years later.

What's more telling-frighteningly so - is the corresponding rise in other autoimmune diseases. According to the book, The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance--and the Cutting-Edge Science that Promises Hope, the incidence of Lupus has tripled in the last forty years and the cases of MS (Multiple Sclerosis) has risen by 30% in Norway, with Greece, Germany and England seeing cases double in the last four decades. Other autoimmune diseases, like vitiligo, Crohn's disease, and Rheumatoid Arthritis, have experienced dramatic increases as well.

When considering the whole of autoimmune diseases, I, like others, can think of many friends and colleagues who are affected by an autoimmune disease more than ever before -- two of my neighbors have MS and another RA; and the son of a close friend was just diagnosed with Crohn's disease. Even Type 1 Diabetes seems more prevalent: my path regularly crosses with two colleagues who both have Type 1 children.

So What Is Going On? Is the higher incidence autoimmune diseases because we are now keeping better records? Do we communicate more effectively so that we are aware of the increased incidence of all autoimmune diseases? Or are other factors at work?

As mentioned above, early in 2010 the Discover article's author, Dan Hurley, released the book Diabetes Rising (reviewed by HealthCentral's David Mendosa), which was hailed for its insights into the rising incidence of Type 1 Diabetes, as well as offering a history on the disease and exploration of potential cures. Some of his five proposed theories as to why we've seen an increase of Type 1 seem to correspond with findings regarding the increases of other autoimmune issues.

The first theory addresses the increased use of and exposure to pollutants and toxins, called the Pop Theory. There's little doubt that the toxins in our bodies are on the rise. In 2005, researchers working with the Environmental Working Group tested the fetal cord blood of ten U.S. newborns and found 287 pollutants, including everything from flame retardants to pesticides. Further support of the link between toxins and autoimmunity comes from a 14-year study conducted by the NIH and the University of Washington that examined 300,000 death certificates in 26 states: workers who handled toxins like pesticides, asbestos and solvents had a significantly greater chance of dying from an autoimmune disease than those who did not.

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Exposure to these toxins may actually repudiate the second theory, the "hygiene hypothesis," which essentially states that since our bodies, and more specifically our immune systems, are no longer exposed to as many pathogens as it had been in days gone by, then autoimmune diseases like Type 1 are due to the immune system going rogue and attacking the body's healthy cells.

The "accelerator hypothesis" has been lined up with the obesity epidemic in children and their likelihood to develop Type 1 and Type 2 diabetes specifically. Developed by Terry Wilkin, a professor of endocrinology and metabolism at Peninsula Medical School in Plymouth England, the theory states that weight serves as the enhancer - or accelerator - to developing diabetes (both types). There have been at least six studies conducted across the world that demonstrate a correlation between weight and the development of both Type 1 and Type 2. A correlation also has been made with rapid growth in height.

The "sunshine hypothesis," which links to reduced levels of Vitamin D to an increase in autoimmune disorders, like Type 1, MS and RA. This theory states that we (particularly kids) spend more time indoors, which thus decreases the amount of sun exposure we receive and therefore reduces the amount of vitamin D we get. When we are outside, we typically use sunscreen, pushing down further our intake of vitamin D.

Finally, the "cow's milk hypothesis" states that the cow's milk that babies receive via baby formula in the first six months of life can cause problems in their immune systems, increasing their risk to developing Type 1 (and other autoimmune diseases) later on.

Time will tell what theory - or I believe a combination of theories - will tell the truth. But the staggering increase in the incidence of all autoimmune diseases, Type 1 included, is like an air raid siren demanding us to sit up, take notice - and figure out fast what is going on. Our children need us to.